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Aim of the Study: a retrospective analysis of Crohn's patients remaining to be taken care in Gastroenterology Department of the Polish Mother's Memorial Hospital, in the period of time between 2002-2007., Material and Methods: A five-year retrospective medical charts of patients with inflammatory bowel disease (IBD) in Gastroenterology Department were studied. The study group with proved CD underwent the analysis according to age, signs, clinical course and activity of the disease, complications, and the type of treatment application., Results: Among 62 children with inflammatory bowel disease 63% (39) patients (aged from 7 months to 18 years) were diagnosed as CD. Most of them were boys (62%), aged above 7 years old, but some cases of very young children (babies) were also noted as Crohn's disease. Among the symptoms most frequently abdominal aches concomitant by loose stools and growth impairment were observed. The most constant laboratory signs of the disease were lower iron concentration in the blood, anaemia and much higher platelets number. Pathology assessment of the biopsy specimens taken from terminal ileus during colonoscopy and the measurements of the thickness of ileum wall on ultrasound examination were the keys in making the final diagnosis, because this part of alimentary tract was most often the localisation of the disease in the study group. High activity index (PCDAI >51) and severe course of the disease were sticking features of most of our patients, especially in younger children. Some severe complications were developed particularly in young patients and in the children with delayed diagnose., Conclusions: CD in children presents a wide heterogeneity of clinical signs and symptoms, high activity, may revealed at any age, more frequently affecting boys. Early age of the onset of the disease and delayed diagnosis and treatment are the risk factors of CD very severe complications developed.

Unlabelled: The incidence of esophageal adenocarcinoma (ADC) has been increasing rapidly over the past few decades. Gastro-esopageal reflux disease (GERD), Barrett's esophagus (BE) and Barrett-associated dysplasia are a risk factor for esophageal cancer, but endoscopic surveillance have only a limited influence on cancer mortality. There is a great need to find molecular biomarkers predicting increased progression risk in GERD-Barrett's metaplasia-dysplasia-adenocarcinoma sequence to improve risk assessment and stratification of patients to surveillance program., Aim of the Study: To evaluate the polymorphism and prevalence of loss of heterozygosity (LOH) of APC tumor suppressor gene in mataplasia, dysplasia and adenocarcinoma., Material and Methods: In esophageal mucosal samples of 79 patients with: GERD (n=33), BE (n=27), BE+dysplasia (n=8) and ADC (n=11) we have studied LOH of APC tumor suppressor gene using PCR-restriction fragment length polymorphism (RFLP). A 133 bp fragment, spanning exon 11 of the APC gene was amplified, and Rsal digestion of the PCR product defined the alleles as either homozygous 133 bp (Rsa(-/-)) or 87 and 46 bp (Rsa(+/+)) fragments, and heterozygous (Rsa(+/-)) exhibiting the three fragments. Control peripheral blood cell DNA samples have been collected from 60 normal healthy subjects., Results: Among 79 patients, there were 16 heterozygous (20%) for APC gene. In 16 informative heterozygous LOH was detected in 7 cases: 2/5 with GERD, 3/7--with BE, 1/2--with BE+dysplasia and 1/2--with ADC. There were no statistical differences between studied groups (NS). Distribution of the three alleles, Rsa(+/-), Rsa(+/+), and Rsa(-/-) was: 38, 47 and 15% in the healthy individuals, 25%, 25% and 50%--in GERD patients, 29%, 41% and 29%--in BE, 36%, 45% and 18% in BE+dysplasia and 25%, 67% and 8% in ADC patients, respectively. The frequency of heterozygous cases in control group was significantly higher than in patients group (p = 0.018), whereas Rsa (-/-) were the most frequent in patients group (p = 0.008). Rsa (-/-) were seen significantly more often in GERD compared to ADC patients (p = 0.005), in opposite to Rsa (+/+), which were significantly more frequent in ADC vs. GERD (p = 0.007)., Conclusions: APC gene inactivation concerns minority of patients with esophageal adenocarcinoma, however, its detection indicates higher risk of progression to ADC. APC alternations appear to be early in GERD-BE-dysplasia-ADC sequence. The specific polymorphism may identify patients with high risk of progression into BE.